Negative Impact of De Novo Malignancies Rather than Alcohol Relapse on Survival After Liver Transplantation for Alcoholic Cirrhosis: A Retrospective Analysis of 305 Patients in a Single Center

Dumortier, Jérôme; Guillaud, Olivier; Adham, Mustapha; Boucaud, Catherine; Delafosse, B.; Bouffard, Y.; Paliard, P; Scoazec, Jean‐Yves; Boillot, Olivier

doi:10.1111/j.1572-0241.2007.01079.x

Cited by 99 publications

(72 citation statements)

References 27 publications

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“…13 One recent large study showed that survival rates following LT in patients with ETOH are similar to the rates for patients with other causes of cirrhosis (89% versus 84% and 84% versus 81% at 3 and 5 years, respectively). 21 Our results show that although there was a trend toward lower patient survival in the NASH group compared to the ETOH group, the difference was not statistically significant. A relatively small number of patients may have accounted for this finding.…”

Section: Discussionmentioning

confidence: 39%

Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease

Bhagat¹,

Mindikoğlu²,

Nudo³

et al. 2009

Liver Transpl

164

142

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Nonalcoholic steatohepatitis (NASH) is becoming a common cause of liver cirrhosis requiring liver transplantation (LT). Cardiovascular complications related to metabolic syndrome and NASH recurrence in the transplanted liver may affect the outcome of LT in these patients. We compared the outcomes of LT for NASH cirrhosis and alcoholic cirrhosis (ETOH) in a large transplant center. A retrospective chart review was performed for all patients who underwent LT for cryptogenic cirrhosis with the NASH phenotype (the NASH group) or ETOH (the ETOH group) at the University of Miami from January 1997 to January 2007. There was no significant difference in survival between the NASH and ETOH groups, despite a trend toward lower survival in the former (P ϭ 0.1699). Sepsis was the leading cause of posttransplant death in both groups, and it was followed by cardiovascular causes in the NASH group (26% versus 7% in the ETOH group, P ϭ 0.21) and malignancies in the ETOH group (29% versus 0% in the NASH group, P ϭ 0.024). Recurrent steatohepatitis (33% versus 0%, P Ͻ 0.0001) and acute rejection (41% versus 23%, P Ͻ 0.023) were significantly more frequent in the NASH group than in the ETOH group. There was no difference in graft failure between the groups (24% in the NASH group versus 18% in the ETOH group, P ϭ 0.3973).In conclusion, despite a numerical trend favoring the ETOH group, there were no statistically significant differences in posttransplant survival and cardiovascular mortality between the NASH and ETOH groups. Acute rejection and recurrent steatohepatitis were significantly more frequent in the NASH group but did not lead to higher rates of retransplantation. Liver

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Section: Discussionmentioning

confidence: 39%

Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease

Bhagat¹,

Mindikoğlu²,

Nudo³

et al. 2009

Liver Transpl

164

142

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“…By hand searching, another 20 articles were identified. When the exclusion criteria were applied, the final 29 studies were included for review ( Figure 1) (2,6,16,36,37,40) were of high, 15 of medium (3,35,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)) and 8 of low quality according to the DQS (38,39,(54)(55)(56)(57)(58)(59). A pretransplantation screening protocol for LTx evaluation was mentioned in 2 studies (16,37 (3,6,37,40,45,52,53).…”

Section: Study Selectionmentioning

confidence: 99%

Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Nicolaas

Jonge²,

Steyerberg

et al. 2010

American Journal of Transplantation

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Liver transplant patients (LTx) have an increased risk for developing de novo malignancies, but for colorectal cancer (CRC) this risk is less clear. We aimed to determine whether the CRC risk post-LTx was increased. A systematic search was performed in MEDLINE and Cochrane databases to identify studies published between 1986 and 2008 reporting on the risk of CRC postLTx. The outcomes were (1) CRC incidence rate (IR per 100 000 person-years (PY)) compared to a weighted age-matched control population using SEER and (2) relative risk (RR) for CRC compared to the general population. If no RR data were available, the RR was estimated using SEER. Twenty-nine studies were included. The overall post-LTx IR was 119 (95% CI 88-161) per 100 000 PY. The overall RR was 2.6 (95% CI 1.7-4.1). The non-primary sclerosing cholangitis (PSC) IR was 129 per 100 000 PY (95% CI 81-207). Compared to SEER (71 per 100 000 PY), the non-PSC RR was 1.8 (95% CI 1.1-2.9). In conclusion, the overall transplants and the subgroup non-PSC transplants have an increased CRC risk compared to the general population. However, in contrast to PSC, non-PSC transplants do not need an intensified screening strategy compared to the general population until a prospective study further defines recommendations.

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“…Interestingly, some studies have suggested that beyond 5 years, reduced survival could be observed in patients transplanted for ALD, whether or not related to alcohol relapse [6,7]. In any case, an increased incidence of squamous cell carcinoma (oropharyngeal and esophageal) has been specifically reported in this population [8].…”

Section: Introductionmentioning

confidence: 98%

Excessive alcohol consumption after liver transplantation impacts on long-term survival, whatever the primary indication

Faure

Herrero

Jung

et al. 2012

Journal of Hepatology

123

103

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Negative Impact of De Novo Malignancies Rather than Alcohol Relapse on Survival After Liver Transplantation for Alcoholic Cirrhosis: A Retrospective Analysis of 305 Patients in a Single Center

Cited by 99 publications

References 27 publications

Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease

Outcomes of liver transplantation in patients with cirrhosis due to nonalcoholic steatohepatitis versus patients with cirrhosis due to alcoholic liver disease

Risk of Colorectal Carcinoma in Post-Liver Transplant Patients: A Systematic Review and Meta-analysis

Excessive alcohol consumption after liver transplantation impacts on long-term survival, whatever the primary indication

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